Potential explanations for the French paradox

French total consumption of saturated fat is similar to that of other developed countries, while French mortality from coronary disease is only one third of the average. Since a distinguishing feature of the French diet is the regular consumption of red wine with meals, studies have focused on the correlation between alcoholic beverage consumption and the risk of coronary heart disease. This has been attributed to several factors: the ethanol itself, the phenols in wine, and a component in the grape skin which may be nitric oxide. Ethanol's cardioprotective effects may be due to its effect on the fibrinolytic factors or to high density lipoprotein concentrations. Phenols in red wine may act as antioxidants or may decrease thromboses. Finally, nitric oxide may relax aortic endothelium. In addition, it has been demonstrated that lower nitric oxide levels may lead to hyperlipidemia in rats. Overall, several wine components show promise for their possible cardiovascular protective effects. Caution, however, is required when formulating recommendations for daily alcohol consumption. (C) 1998 Elsevier Science Inc.